It used to be that our beloved NHS was in crisis every winter. But now the NHS seems to be permanently in crisis. And every year we’re told the NHS needs ever more of our money and ever more staff. In this week’s budget it was handed another few billion which will no doubt disappear down the massive toilet of waste and profligacy that is our national healthcare service.
I realise we have had the pandemic and then seemingly endless strikes by doctors and others. But the NHS’s problems started long before the pandemic and the strikes.
Last week the Office for National Statistics (ONS) released data showing the number of staff by main work categories for each of the constituent parts of the U.K. – England, Scotland, Wales and Northern Ireland. (These figures are expressed as FTEs – full-time equivalents – so this takes account of people who may be working part-time.)
As each of the countries classes NHS employees in slightly different ways, it’s difficult to get reliable total NHS employee figures for the whole U.K. However, if we just look at the largest part of the NHS – NHS England – we can get a reasonable idea of what’s going on. Here’s a summary chart produced by the ONS:
Now let’s look at the numbers:
- The number of doctors increased by 37,467 (up 37%) from 101,137 in 2013 to 138,604 by 2023.
- The number of nurses and midwives increased by 68,063 (up 23%) from 295,163 in 2013 to 363,226 in 2023.
- The number of scientific staff increased by 42,938 (up 13%) from 123,912 in 2013 to 166,850 in 2023.
- The number of support staff increased by 125,510 (up 45%) from 279,579 in 2013 to 405,089 in 2023.
- The number of infrastructure staff increased by 62,758 (up 41%) from 152,437 in 2013 to 215,195 in 2023.
- The number of ambulance staff increased by just 1,721 (up 10%) from 17,537 in 2013 to 19,258 in 2023.
Here are just a few things you might have noticed:
- The total number of staff increased by 338,4577 (35%) from 969,765 in 2013 to 1,308,222 in 2023.
- The largest increases were in non-medical staff, with support staff shooting up by 45% and infrastructure staff rising by 41%.
- The smallest increase was in ambulance staff – up just 10%. Some people might find that slightly worrying. But don’t worry, at the same time as the number of ambulance staff has gone up by only 1,721, the number of DIE (diversity, inclusion and equality) managers has shot up from virtually none in 2013 to more than 800 now. So, if an ambulance does actually manage to reach you before you croak it, the ambulance workers will no doubt be wonderfully racially and gender diverse, which is what you absolutely want from an ambulance service.
We’re constantly told that one reason the NHS is collapsing is a rising population. But the population of England only rose by around 7% between 2013 and 2023. At the same time the number of doctors rose by 37% and the number of nurses and midwives rose by 23%. In Scotland the number of NHS staff rose by about 20% while the population only rose by around 2.7%. In Wales NHS staff numbers increased by 32% while the population only went up by 2%. And in Northern Ireland, NHS staff numbers rose by 20% while the population only increased by 4%. So the excuse of the NHS needing many more staff to cope with a rapidly rising population doesn’t hold water.
Another reason given for the NHS’s constant state of disintegration is that the U.K. population is getting older. Over the period from 2013 to 2023 the mean age of the U.K.’s population rose from 39 years to about 41.5 years – a rise of 6.4%. So this excuse seems pretty flimsy, too.
And then there’s the usual bleating that we don’t spend as much on health as other developed countries. It’s true that we spend less per capita than several European countries. But U.K. health spending per capita is on the OECD average:
While there is some truth in the claim that some other countries spend much more per capita on health, many spend less and we don’t hear about their health systems collapsing like our beloved NHS. So levels of spending and staffing cannot be the only reasons for the utter chaos in our health service.
A better explanation for the NHS’s floundering failure can possibly be seen in the massive increase in non-medical staff – an increase in support staff in the NHS England of an astonishing 45% and in infrastructure staff of 41%. It’s not obvious why a population which has increased by just 7% between 2013 and 2023 and which has got very slightly older should require such a huge rise in non-medical NHS staff. And there has been a 22% increase in NHS administrative staff in Scotland, Wales and Northern Ireland yet the population served by the NHS there has only gone up by around 2.7%.
But you can look at the numbers, think about your own, your friends’ and your families’ experiences of our pitiful NHS and make up your own minds about the competence of NHS management and the fact that our NHS seems to be doing ever less with ever more money and ever more staff.
David Craig is the author of There is No Climate Crisis, available as an e-book or paperback from Amazon.
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